Journal of Current Glaucoma Practice

Register      Login

VOLUME 7 , ISSUE 3 ( September-December, 2013 ) > List of Articles

REVIEW ARTICLE

Evaluation of the Optic Nerve Head in Glaucoma

Monica Gandhi, Suneeta Dubey

Keywords : Optic disk, Optic cup, Neuroretinal rim, Optic disk hemorrhage, Retinal nerve fiber layer, Parapaillary atrophy, Disk anomalies

Citation Information : Gandhi M, Dubey S. Evaluation of the Optic Nerve Head in Glaucoma. J Curr Glaucoma Pract 2013; 7 (3):106-114.

DOI: 10.5005/jp-journals-10008-1146

License: CC BY-NC 4.0

Published Online: 00-12-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Glaucoma is an optic neuropathy leading to changes in the intrapaillary and parapaillary regions of the optic disk. Despite technological advances, clinical identification of optic nerve head characteristics remains the first step in diagnosis. Careful examination of the disk parameters including size, shape, neuroretinal rim shape and pallor; size of the optic cup in relation to the area of the disk; configuration and depth of the optic cup; ratios of cup-to-disk diameter and cup-to-disk area; presence and location of splinter-shaped hemorrhages; occurrence, size, configuration, and location of parapapillary chorioretinal atrophy; and visibility of the retinal nerve fiber layer (RNFL) is important to differentiate between the glaucomatous and nonglaucomatous optic neuropathy.


PDF Share
  1. Nangia V, Matin A, Bhojwani K, Kulkarni M, Yadav M, Jonas JB. Optic disc size in a population-based study in central India: the Central India Eye and Medical Study (CIEMS). Acta Ophthalmol 2008 Feb;86(1):103-104.
  2. Jonas JB, Thomas R, George R, Berenshtein E, Muliyil J. Optic disc morphology in south India: the Vellore Eye Study. Br J Ophthalmol 2003 Feb;87(2):189-196.
  3. Sekhar GC, Prasad K, Dandona R, John RK, Dandona L. Planimetric optic disc parameters in normal eyes: a populationbased study in South India. Indian J Ophthalmol 2001 Mar;49(1):19-23.
  4. Jonas JB, Gusek GC, Naumann GO. Optic disc, cup and neuroretinal rim size, configuration and correlations in normal eyes. Invest Ophthalmol Vis Sci 1988 Jul;29(7):1151-1158.
  5. Ramrattan RS, Wolfs RC, Jonas JB, Hofman A, de Jong PT. Determinants of optic disk characteristics in a general population. The Rotterdam Study. Ophthalmology 1999 Aug;106(8):1588-1596.
  6. Oliveira C, Harizman N, Girkin CA, Xie A, Tello C, Liebmann JM, Ritch R. Axial length and optic disc size in normal eyes. Br J Ophthalmol 2007 Jan;91(1):37-39.
  7. Jonas JB, Fernández MC. Shape of the neuroretinal rim and position of the central retinal vessels in glaucoma. Br J Ophthalmol 1994 Feb;78(2):99-102.
  8. Kirwan JF, Gouws P, Linnell AE, Crowston J, Bunce C. Pharmacological mydriasis and optic disc examination. Br J Ophthalmol 2000 Aug;84(8):894-898.
  9. Ansari-Shahrezaei S, Maar N, Biowski R, Stur M. Biomicroscopic measurement of the optic disc with a high-power positive lens. Invest Ophthalmol Vis Sci 2001 Jan;42(1):153-157.
  10. Garway-Heath DF, Rudnicka AR, Lowe T, Foster PJ, Fitzke FW, Hitchings RA. Measurement of optic disc size: equivalence of methods to correct for ocular magnification. Br J Ophthalmol 1998 Jun;82(6):643-649.
  11. Gross PG, Drance SM. Comparison of a simple ophthalmoscopic and planimetric measurement of glaucomatous neuroretinal rim areas. J Glaucoma 1995 Oct;4(5):314-316.
  12. Jonas JB, Kling F, Gründler AE. Optic disc shape, corneal astigmatism, and amblyopia. Ophthalmology 1997 Nov;104(11):1934-1937.
  13. Schwartz B. Optic disc changes in ocular hypertension. Surv Ophthalmol 1980 Nov-Dec;25(3):148-154.
  14. Hitchings RA, Spaeth GL. The Optic disc in glaucoma II: correlation of the appearance of the optic disc with the visual field. Br J Ophthalmol 1977 Feb;61(2):107-113.
  15. Arvind H, George R, Raju P, Ve RS, Mani B, Kannan P, Vijaya L. Neural rim characteristics of healthy South Indians: the Chennai Glaucoma Study. Invest Ophthalmol Vis Sci 2008 Aug;49(8): 3457-3464.
  16. Healey PR, Mitchell P, Smith W, Wang JJ. Optic disc hemorrhages in a population with and without signs of glaucoma. Ophthalmology 1998 Feb;105(2):216-223.
  17. Budenz DL, Anderson DR, Feuer WJ, Beiser JA, Schiffman J, Parrish RK 2nd, Piltz-Seymour JR, Gordon MO, Kass MA; Ocular Hypertension Treatment Study Group. Detection and prognostic significance of optic disc hemorrhages during the Ocular Hypertension Treatment Study. Ophthalmology 2006 Dec;113(12):2137-2143.
  18. Lan YW, Wang IJ, Hsiao YC, Sun FJ, Hsieh JW. Characteristics of disc hemorrhage in primary angle-closure glaucoma. Ophthalmology 2008 Aug;115(8):1328-1333.e1.
  19. Dandona L, Dandona R, Srinivas M, Mandal P, John RK, McCarty CA, Rao GN. Open-angle glaucoma in an urban population in southern India: the Andhra Pradesh eye disease study. Ophthalmology 2000 Sep;107(9):1702-1709.
  20. Drance SM, Begg IS. Sector haemorrhage—a probable acute ischaemic disc change in chronic simple glaucoma. Can J Ophthalmol 1970 Apr;5(2):137-141.
  21. Quigley HA, Addicks EM, Green WR, Maumenee AE. Optic nerve damage in human glaucoma. II. The site of injury and susceptibility to damage. Arch Ophthalmol 1981 Apr;99(4):635-649.
  22. Jonas JB, Budde WM. Optic nerve head appearance in juvenileonset chronic high-pressure glaucoma and normal-pressure glaucoma. Ophthalmology 2000 Apr;107(4):704-711.
  23. Jonas JB, Schiro D. Localised wedge shaped defects of the retinal nerve fibre layer in glaucoma. B J Ophthalmol 1994 Apr;78(4):285- 290.
  24. Quigley HA, Katz J, Derick RJ, Gilbert D, Sommer A. An evaluation of optic disc and nerve fiber layer examinations in monitoring progression of early glaucoma damage. Ophthalmology 1992 Jan;99(1):19-28.
  25. Airaksinen PJ, Mustonen E, Alanko HI. Optic disc haemorrhages precede retinal nerve fibre layer defects in ocular hypertension. Acta Ophthalmol (Copenh) 1981 Oct;59(5):627-641.
  26. Jonas JB, Fernandez MC, Naumann GO. Glaucomatous optic nerve atrophy in small discs with low cup-to-disc ratios. Ophthalmology 1990 Sep;97(9):1211-1215.
  27. Brodsky MC. Congenital optic disk anomalies. Surv Ophthalmol 1994 Sep-Oct;39(2):89-112.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.